Healthcare Provider Details

I. General information

NPI: 1144959230
Provider Name (Legal Business Name): MACKENZIE MEEHAN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 DIVISION ST
AMSTERDAM NY
12010-1018
US

IV. Provider business mailing address

365 DIVISION ST
AMSTERDAM NY
12010-1018
US

V. Phone/Fax

Practice location:
  • Phone: 518-665-3533
  • Fax: 518-945-9946
Mailing address:
  • Phone: 518-665-3533
  • Fax: 518-945-9946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR0008509
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX014054-01
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR010603
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: